Healthcare Provider Details

I. General information

NPI: 1447131321
Provider Name (Legal Business Name): WAKE TRANSPORTATION AND SOCIAL ASSISTANCE GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2025
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4704 CARDINAL GROVE BLVD
RALEIGH NC
27616-2977
US

IV. Provider business mailing address

4704 CARDINAL GROVE BLVD
RALEIGH NC
27616-2977
US

V. Phone/Fax

Practice location:
  • Phone: 984-328-2732
  • Fax: 984-328-2732
Mailing address:
  • Phone: 984-328-2732
  • Fax: 984-328-2732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. TONYA TONYA
Title or Position: OWNER
Credential:
Phone: 984-328-2732